Everything You Need To Know About E-Cigarettes: Are They Really A Healthier Alternative To Smoking?

This past weekend, a city-wide ban of electronic cigarettes went into effect in Los Angeles. Before the new law, vapors — as e-cigarette users like to call themselves — enjoyed inhaling their liquid nicotine in public spaces like bars, beaches, restaurants and parks. Now, electronic-smoking devices are prohibited in the same areas as traditional tobacco, following other majors cities like New York, Chicago and Philadelphia.

Of course, the new measure did not come without controversy and debate. Last month, vapor shops and smoking groups across town protested the bill after it was voted into effect by city council. While they failed to overturn the regulation, protesters did encourage lawmakers to continue allowing e-cigarette use in vaping lounges. Jett Conley, an employee at Natural Vapes in West Los Angeles, said there’s been a lot of complaining from customers. “It’s nice that you can vape in vape shops, but as soon as you step out it’s illegal now,” he said. “People want to go to the park and movie theater and vape freely.” He went on to tell HelloBeautiful that he saw the ban coming, “I just didn’t expect it to happen the way it happened, without warning or the proper data.”

Conley has a point. E-cigarettes first hit the U.S. market in 2007, and while the battery-powered devices quickly grew in popularity, there’s not much research that proves they are equally, or more, dangerous than tobacco products. They are designed to look like regular cigarettes but contain no tobacco, no smoky smell and don’t require a match. The device, which converts liquid nicotine into a mist or vapor, also excludes harmful chemicals like carbon dioxide and tar. Some users even say the smokeless alternative helped kill their addiction to traditional cancer sticks. So if there’s no data that proves second-hand vapor is harmful, no evidence that concludes it causes cancer, and users claim it helps smokers quit, then what’s all the fuss about?

Well, this is what we do know about electronic products: they are not regulated by the Food and Drug Administration. According to Elizabeth Klein, a professor in the Center of Excellence in Regulatory Tobacco Science at Ohio State University, medical professionals will have a better idea if the chemicals in e-liquids cause cancer when the FDA finally steps in. “Certainly we know that the risks related with combustible tobacco are very well established and we know those are risks we understand very well. We don’t have good data as far as the risks applying those chemicals that are in e-liquids into the lungs,” she explained. “A lot of the pulmonary tests done on the e-liquids products have suggested that there’re pretty poor control on what’s contained in these e-liquids. For instance, when the FDA conducted some of these studies they found that some of the e-liquids that claimed not to contain nicotine actually contained nicotine.”

The term “e-cigarettes” refers to over 400 products in the US. With such a huge variability in product characteristics and absolutely no regulatory oversight or standardization, Dr. Frank T. Leone, the director of the Comprehensive Smoking Treatment Program at the University of Pennsylvania, says “this degree of variability in itself is a risk, given that the public has no assurance from the manufacturers regarding the constituents.”

In his opinion, the idea that e-cigarettes are safe is the inevitable conclusion from marketing aimed at smoker’s vulnerabilities. While there appear to be very few short-term health risks, Leone said the “products haven’t been available long enough (or studied carefully enough) to know for sure that there are no long-term effects.”

“Parenthetically, the long-term effects of propylene glycol inhalation are unknown but are likely very different from traditional cigarette risks. For example, there’s a theoretical risk of liver disease or vision problems, which you wouldn’t expect from cigarettes,” he shared. “I think people have been led to believe that e-cigarettes are harmless in a number of ways. For example the term “vaping” is a made up word, probably designed to soften the idea that you are inhaling an aerosol of heated propylene glycol. I think most people connect the idea of water vapor with the term “vaping.” The idea that what you see when you exhale the e-cigarette aerosol is the same harmless stuff that makes up clouds is false. Though the solution may be dissolved in water, what you are seeing is the particulate suspension of propylene glycol or glycerin in air.”

Darrin Gold is one of the users who believes e-cigarettes are a safer, healthier alternative to smoking. The 43-year-old Southern California native claims the battery-powered devices helped kick his nearly three-decade-long smoking habit. “I was a smoker for 27 years, for most of that 27 years two packs a day,” he shared. “I tried to stop to quit using the patch, I tried to quit using the lozenge, I tried to quit using the gum. I didn’t have much, if any, luck with those. Most of those had side effects that were probative…I found electronic cigarettes at the 7/11 in December of 2010 and I haven’t had a cigarette since that day.” Gold started the L.A. Vapers Club three years ago (a group of about 220 vapors and industry manufactures who meet monthly to network and socialize) and he said many of the members share his experience.

Dr. Leone’s opinion on this? “The e-cigarette may someday be a reliable option to help people avoid the danger of traditional smoking,” but, he added, “it’s just not there yet.”

When it comes to second-hand smoke, Dr. Klein said the risks related to vapor exposure have not been established. “That doesn’t necessarily mean the vapor is risk free, it’s that we don’t necessarily know enough about it. If you look at vapor in comparison to the smoke that is created from second-hand smoke, they are very different products. The are very different elements that are being produced,” she said. “But we still don’t know enough about what is contained in the vapor to really have a good understanding of what the risks might be for more vulnerable populations, like children and others.”

“The argument about including e-cigarettes in tobacco-controlled products has more to do with the social norm factor, promoting a tobacco-free norm,” Klein explained about the growing number of cities banning the products in public spaces. “It’s not necessarily because they are creating second-hand smoke — they are creating vapor — but part of the justification is for consistency in terms of social norms, which has been demonstrated to prevent usage among kids in particular.”

Dr. Leone agreed. “City restrictions on e-cigarette use is a good idea. Despite the fact that marketers would like to position their products as available to use in places where cigarette smoking is forbidden, e-cigarettes should not be an acceptable alternative,” he said.

He went on to share the first time he was struck by this. ”I had been asked for my opinion about a patient in the chemotherapy unit of my hospital – he wanted to use the e-cigarette while in the chemo chair,” he recalled. “He wanted to use the e-cig to help himself be calm and comfortable during his ordeal. I understood this, but was equally concerned with the other smokers present who were trying to quit. Allowing the e-cigarette wouldn’t be just discourteous, it would also be a significant visual trigger to smoke.”

“For similar reasons,” he continued, “if LA and other cities want to continue to provide a smoke-free environment, one in which smokers won’t be made uncomfortable and triggered to smoke, they need to keep e-cigarette use confined to spaces where smoking is currently allowed. I believe this will be a trend elsewhere as well.”

According to Klein, it may be another year before e-cigarettes are be under FDA authority and we gain adequate information about the risks and health effects. “There are a lot of steps in the process in order for the FDA to exert their authority over the product. In the meanwhile, there are a lot of manufactures out there sending that message without any FDA regulation. Which is scary because at the end of the day, the consumer may be misinformed if incorrect information is distributed,” she said. “We really do need FDA authority just to make sure that these products are making appropriate claims and to better understand what the products are themselves.”